ArticleJournal of pain research2026
Long-Acting versus Short-Acting Opioids and Opioid-Related Disorders in Chronic Non-Cancer Pain: A Claims Data Analysis in Germany.
Article in Journal of pain research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Chronic non-cancer pain is common in primary care and may be managed with long-term opioid therapy. The German guideline "Long-term Use of Opioids for Chronic Non-Cancer Pain" provides recommendations for such treatment. The role of opioid formulation (long-acting vs. short-acting) and the association with opioid-related disorders remains underexplored. This study aims to explore associations between opioid formulation and opioid-related disorders in patients with chronic non-cancer pain receiving long-term opioid therapy in German general practices. Methods: We conducted a retrospective cross-sectional claims data analysis using data from one statutory health insurer in Baden-Württemberg (AOK), Germany, for the year 2021. The analysis included patients aged ≥18 years who received at least one oral or transdermal opioid prescription in all four quarters. Exclusion criteria were malignant diseases or palliative care. The outcome was opioid-related disorder (ICD-10 category F11.-). Multivariable logistic regression analyses were performed to identify predictors. Results: Multiple models were calculated. The main model included a total of 34,205 patients. The mean age was 70 years, and 65% were female. Overall, 3.1% of patients were diagnosed with an opioid-related disorder. Weak opioids were most frequently prescribed. Long-acting opioids predominated. Higher odds of opioid-related disorders were observed in patients with substance use disorders involving such as sedatives (OR = 5.6, 95% CI: 4.48-7.01) or alcohol (OR = 2.2, 95% CI: 1.82-2.66). Short-acting opioids (OR = 2.0, 95% CI: 1.53-2.48) and combined long- and short-acting therapy (OR = 3.5, 95% CI: 2.38-5.00) were associated with higher odds of opioid-related disorders compared with long-acting opioids (all p <0.001). Conclusion: The results suggest that short-acting opioids, either alone or as part of combination therapy, may be more strongly associated with opioid-related disorders in patients with chronic non-cancer pain and long-term opioid therapy than long-acting opioids alone. Further research is needed to clarify these relationships and their underlying causes.
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